|
HC FACTOR X ASSAY
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 85260
|
| Hospital Charge Code |
30500031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$34.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$40.42
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC FACTOR X ASSAY
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 85260
|
| Hospital Charge Code |
30500031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UMR Bronson Commercial |
$48.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC FACTOR XI ASSAY
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 85270
|
| Hospital Charge Code |
30500032
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$34.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC FACTOR XI ASSAY
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 85270
|
| Hospital Charge Code |
30500032
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC FACTOR XII ASSAY
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 85280
|
| Hospital Charge Code |
30500033
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC FACTOR XII ASSAY
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 85280
|
| Hospital Charge Code |
30500033
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$36.98
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC FACTOR XIII, FUNCTIONAL
|
Facility
|
IP
|
$181.56
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$79.89 |
| Max. Negotiated Rate |
$163.40 |
| Rate for Payer: Aetna American Axle |
$118.01
|
| Rate for Payer: Aetna Commercial |
$154.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.01
|
| Rate for Payer: Cash Price |
$145.25
|
| Rate for Payer: Cofinity Commercial |
$127.09
|
| Rate for Payer: Cofinity Commercial |
$156.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.25
|
| Rate for Payer: Healthscope Commercial |
$163.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.33
|
| Rate for Payer: PHP Commercial |
$154.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.01
|
| Rate for Payer: Priority Health SBD |
$114.38
|
| Rate for Payer: UMR Bronson Commercial |
$79.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.17
|
|
|
HC FACTOR XIII, FUNCTIONAL
|
Facility
|
OP
|
$181.56
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$163.40 |
| Rate for Payer: Aetna American Axle |
$118.01
|
| Rate for Payer: Aetna Commercial |
$154.33
|
| Rate for Payer: Aetna Medicare |
$16.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.43
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$16.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.34
|
| Rate for Payer: Cash Price |
$145.25
|
| Rate for Payer: Cash Price |
$145.25
|
| Rate for Payer: Cofinity Commercial |
$156.14
|
| Rate for Payer: Cofinity Commercial |
$127.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.34
|
| Rate for Payer: Healthscope Commercial |
$163.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.17
|
| Rate for Payer: Mclaren Medicaid |
$8.76
|
| Rate for Payer: Mclaren Medicare |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.16
|
| Rate for Payer: Meridian Medicaid |
$9.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.33
|
| Rate for Payer: PACE Medicare |
$15.52
|
| Rate for Payer: PACE SWMI |
$16.34
|
| Rate for Payer: PHP Commercial |
$154.33
|
| Rate for Payer: PHP Medicare Advantage |
$16.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.01
|
| Rate for Payer: Priority Health Medicare |
$16.34
|
| Rate for Payer: Priority Health SBD |
$114.38
|
| Rate for Payer: Railroad Medicare Medicare |
$16.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.34
|
| Rate for Payer: UHC Exchange |
$31.23
|
| Rate for Payer: UHC Medicare Advantage |
$16.34
|
| Rate for Payer: UHCCP Medicaid |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$67.18
|
| Rate for Payer: VA VA |
$16.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.17
|
|
|
HC FACTOR XIII QUAL
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.71 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC FACTOR XIII QUAL
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$16.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.43
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$16.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.34
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.34
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$8.76
|
| Rate for Payer: Mclaren Medicare |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.16
|
| Rate for Payer: Meridian Medicaid |
$9.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PACE Medicare |
$15.52
|
| Rate for Payer: PACE SWMI |
$16.34
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$16.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health Medicare |
$16.34
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: Railroad Medicare Medicare |
$16.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.34
|
| Rate for Payer: UHC Exchange |
$31.23
|
| Rate for Payer: UHC Medicare Advantage |
$16.34
|
| Rate for Payer: UHCCP Medicaid |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$42.65
|
| Rate for Payer: VA VA |
$16.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
IP
|
$91.45
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$40.24 |
| Max. Negotiated Rate |
$82.31 |
| Rate for Payer: Aetna American Axle |
$59.44
|
| Rate for Payer: Aetna Commercial |
$77.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.44
|
| Rate for Payer: Cash Price |
$73.16
|
| Rate for Payer: Cofinity Commercial |
$64.02
|
| Rate for Payer: Cofinity Commercial |
$78.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.16
|
| Rate for Payer: Healthscope Commercial |
$82.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.73
|
| Rate for Payer: PHP Commercial |
$77.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.44
|
| Rate for Payer: Priority Health SBD |
$57.61
|
| Rate for Payer: UMR Bronson Commercial |
$40.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.59
|
|
|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
OP
|
$91.45
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$441.09 |
| Rate for Payer: Aetna American Axle |
$59.44
|
| Rate for Payer: Aetna Commercial |
$77.73
|
| Rate for Payer: Aetna Medicare |
$162.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$73.16
|
| Rate for Payer: Cash Price |
$73.16
|
| Rate for Payer: Cofinity Commercial |
$78.65
|
| Rate for Payer: Cofinity Commercial |
$64.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$82.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.59
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.73
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$77.73
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.44
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health SBD |
$57.61
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$299.47
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: VA VA |
$156.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.59
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
OP
|
$4,336.49
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,604.50 |
| Max. Negotiated Rate |
$3,902.84 |
| Rate for Payer: Aetna American Axle |
$2,818.72
|
| Rate for Payer: Aetna Commercial |
$3,686.02
|
| Rate for Payer: Aetna Medicare |
$2,168.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,818.72
|
| Rate for Payer: BCBS Complete |
$1,734.60
|
| Rate for Payer: Cash Price |
$3,469.19
|
| Rate for Payer: Cofinity Commercial |
$3,035.54
|
| Rate for Payer: Cofinity Commercial |
$3,729.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,469.19
|
| Rate for Payer: Healthscope Commercial |
$3,902.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,035.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,252.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,686.02
|
| Rate for Payer: PHP Commercial |
$3,686.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,818.72
|
| Rate for Payer: Priority Health SBD |
$2,731.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,604.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,252.37
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
IP
|
$4,336.49
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,908.06 |
| Max. Negotiated Rate |
$3,902.84 |
| Rate for Payer: Aetna American Axle |
$2,818.72
|
| Rate for Payer: Aetna Commercial |
$3,686.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,818.72
|
| Rate for Payer: Cash Price |
$3,469.19
|
| Rate for Payer: Cofinity Commercial |
$3,035.54
|
| Rate for Payer: Cofinity Commercial |
$3,729.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,469.19
|
| Rate for Payer: Healthscope Commercial |
$3,902.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,035.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,252.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,686.02
|
| Rate for Payer: PHP Commercial |
$3,686.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,818.72
|
| Rate for Payer: Priority Health SBD |
$2,731.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,908.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,252.37
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
OP
|
$8,726.47
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$5,672.21
|
| Rate for Payer: Aetna Commercial |
$7,417.50
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,672.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,981.18
|
| Rate for Payer: Cash Price |
$6,981.18
|
| Rate for Payer: Cofinity Commercial |
$7,504.76
|
| Rate for Payer: Cofinity Commercial |
$6,108.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,853.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,108.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.85
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,417.50
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,417.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,672.21
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,497.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$3,228.79
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.85
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
IP
|
$8,726.47
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,839.65 |
| Max. Negotiated Rate |
$7,853.82 |
| Rate for Payer: Aetna American Axle |
$5,672.21
|
| Rate for Payer: Aetna Commercial |
$7,417.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,672.21
|
| Rate for Payer: Cash Price |
$6,981.18
|
| Rate for Payer: Cofinity Commercial |
$6,108.53
|
| Rate for Payer: Cofinity Commercial |
$7,504.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.18
|
| Rate for Payer: Healthscope Commercial |
$7,853.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,108.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,417.50
|
| Rate for Payer: PHP Commercial |
$7,417.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,672.21
|
| Rate for Payer: Priority Health SBD |
$5,497.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,839.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.85
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
IP
|
$154.10
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$138.69 |
| Rate for Payer: Aetna American Axle |
$100.17
|
| Rate for Payer: Aetna Commercial |
$130.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.17
|
| Rate for Payer: Cash Price |
$123.28
|
| Rate for Payer: Cofinity Commercial |
$107.87
|
| Rate for Payer: Cofinity Commercial |
$132.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.28
|
| Rate for Payer: Healthscope Commercial |
$138.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.99
|
| Rate for Payer: PHP Commercial |
$130.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health SBD |
$97.08
|
| Rate for Payer: UMR Bronson Commercial |
$67.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.58
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
OP
|
$154.10
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$138.69 |
| Rate for Payer: Aetna American Axle |
$100.17
|
| Rate for Payer: Aetna Commercial |
$130.99
|
| Rate for Payer: Aetna Medicare |
$19.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.46
|
| Rate for Payer: BCBS Complete |
$10.56
|
| Rate for Payer: BCBS MAPPO |
$18.77
|
| Rate for Payer: BCN Medicare Advantage |
$18.77
|
| Rate for Payer: Cash Price |
$123.28
|
| Rate for Payer: Cash Price |
$123.28
|
| Rate for Payer: Cofinity Commercial |
$132.53
|
| Rate for Payer: Cofinity Commercial |
$107.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$138.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.58
|
| Rate for Payer: Mclaren Medicaid |
$10.06
|
| Rate for Payer: Mclaren Medicare |
$18.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.71
|
| Rate for Payer: Meridian Medicaid |
$10.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.99
|
| Rate for Payer: PACE Medicare |
$17.83
|
| Rate for Payer: PACE SWMI |
$18.77
|
| Rate for Payer: PHP Commercial |
$130.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health Medicare |
$18.77
|
| Rate for Payer: Priority Health SBD |
$97.08
|
| Rate for Payer: Railroad Medicare Medicare |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.77
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$18.77
|
| Rate for Payer: UHCCP Medicaid |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$57.02
|
| Rate for Payer: VA VA |
$18.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.58
|
|
|
HC FDG PER DOSE
|
Facility
|
IP
|
$777.96
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$342.30 |
| Max. Negotiated Rate |
$700.16 |
| Rate for Payer: Aetna American Axle |
$505.67
|
| Rate for Payer: Aetna Commercial |
$661.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.67
|
| Rate for Payer: Cash Price |
$622.37
|
| Rate for Payer: Cofinity Commercial |
$544.57
|
| Rate for Payer: Cofinity Commercial |
$669.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.37
|
| Rate for Payer: Healthscope Commercial |
$700.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.27
|
| Rate for Payer: PHP Commercial |
$661.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.67
|
| Rate for Payer: Priority Health SBD |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$342.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.47
|
|
|
HC FDG PER DOSE
|
Facility
|
OP
|
$777.96
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$287.85 |
| Max. Negotiated Rate |
$700.16 |
| Rate for Payer: Aetna American Axle |
$505.67
|
| Rate for Payer: Aetna Commercial |
$661.27
|
| Rate for Payer: Aetna Medicare |
$388.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.67
|
| Rate for Payer: BCBS Complete |
$311.18
|
| Rate for Payer: Cash Price |
$622.37
|
| Rate for Payer: Cofinity Commercial |
$544.57
|
| Rate for Payer: Cofinity Commercial |
$669.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.37
|
| Rate for Payer: Healthscope Commercial |
$700.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.27
|
| Rate for Payer: PHP Commercial |
$661.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.67
|
| Rate for Payer: Priority Health SBD |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$287.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.47
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
OP
|
$34.22
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna American Axle |
$22.24
|
| Rate for Payer: Aetna Commercial |
$29.09
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$30.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.09
|
| Rate for Payer: PACE Medicare |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$29.09
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.24
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health SBD |
$21.56
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Exchange |
$9.75
|
| Rate for Payer: UHC Medicare Advantage |
$5.10
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$12.66
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
IP
|
$34.22
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna American Axle |
$22.24
|
| Rate for Payer: Aetna Commercial |
$29.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.24
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.38
|
| Rate for Payer: Healthscope Commercial |
$30.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.09
|
| Rate for Payer: PHP Commercial |
$29.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.24
|
| Rate for Payer: Priority Health SBD |
$21.56
|
| Rate for Payer: UMR Bronson Commercial |
$15.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$9.00
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.80
|
| Rate for Payer: UHC Exchange |
$32.11
|
| Rate for Payer: UHC Medicare Advantage |
$16.80
|
| Rate for Payer: UHCCP Medicaid |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: VA VA |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna American Axle |
$35.01
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$33.93
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$19.93
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
